Abstract
Purpose :
A face-down position is required for restoration after pars plana vitrectomy and gas tamponade for primary rhegmatogenous retinal detachment (RRD). However, existing literature indicates a strict face-down position is not necessarily required. This study aims to evaluate the safety and efficacy of a minimal and adjustable postoperative position.
Methods :
This study retrospectively reviewed 40 eyes from 39 patients (10 women (25.6%) and 29 men (74.4%) with a mean age of 59.2±13.0 years) with primary RRD who had undergone pars plana vitrectomy at the Aichi Medical University Hospital from September 2015 to August 2017, and were able to be followed up for at least three months (mean follow-up period of 7.2±4.5 months).
All eyes underwent pars plana vitrectomy, with 20% sulfur hexafluoride (SF6) or 10-to-14% perfluoropropane (C3F8) given as gas tamponade in the postoperative period, concomitant with cataract surgery. The postoperative position was either with the tear face up or no position restrictions used, while patients with macula detachment were positioned face down for a night from several houres.
The patients were assessed for preoperative and postoperative best-corrected visual acuity (BCVA), anatomical retinal reattachment rate, and postoperative complications.
Results :
The mean number of quadrants affected was 1.8 (range of 1－4). A single tear was present in 35 patients (75.0%), while multiple retinal tears were present in 9 patients (22.5%) and dialysis in 1 patient (2.5%). The macula was detached in 14 patients (35.0%) and attached in 26 patients (65.0%). The anatomical success rate after primary surgery was 90.0% (36 cases).
The mean preoperative BCVA was a 0.75±0.96 logarithm angle of resolution (logMAR), while the mean final postoperative BCVA was a 0.12±0.20 logMAR (P＜0.001).
Postoperative complications included intraocular pressure elevation (≧25mHg) in 11 patients (27.5%), fibrinous uveitis in 2 patients (5.0%), pupillary capture of intraocular lens in 2 patients (5.0%), and posterior synechia in 1 patient (2.5%).
Conclusions :
A minimal and adjustable postoperative position after pars plana vitrectomy and gas tamponade for primary RRD is effective and safe. Furthermore, restoration does not necessarily require strict face-down and other position restrictions.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.